Provider Demographics
NPI:1457725210
Name:NEW, COLTEN MCDANIEL (BCBA)
Entity Type:Individual
Prefix:
First Name:COLTEN
Middle Name:MCDANIEL
Last Name:NEW
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 ARBORETUM PL
Mailing Address - Street 2:SUITE 502
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-3475
Mailing Address - Country:US
Mailing Address - Phone:804-887-2990
Mailing Address - Fax:
Practice Address - Street 1:300 ARBORETUM PL
Practice Address - Street 2:SUITE 502
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3475
Practice Address - Country:US
Practice Address - Phone:804-887-2990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0134000131103K00000X
VA0133001133103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst